Effects of tertiary palliative care on the pattern of end-of-life care in patients with hematologic malignancies in Korea
Dong Hyun Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Search for more papers by this authorJeonghwan Youk
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorJa Min Byun
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorYoungil Koh
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Search for more papers by this authorJunshik Hong
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Search for more papers by this authorTae Min Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorInho Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorSung-Soo Yoon
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorCorresponding Author
Shin Hye Yoo
Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea
Correspondence
Shin Hye Yoo, Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Dong-Yeop Shin, Department of Internal Medicine, Seoul National University Hospital, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Dong-Yeop Shin
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Correspondence
Shin Hye Yoo, Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Dong-Yeop Shin, Department of Internal Medicine, Seoul National University Hospital, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Search for more papers by this authorDong Hyun Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Search for more papers by this authorJeonghwan Youk
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorJa Min Byun
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorYoungil Koh
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Search for more papers by this authorJunshik Hong
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Search for more papers by this authorTae Min Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorInho Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorSung-Soo Yoon
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Search for more papers by this authorCorresponding Author
Shin Hye Yoo
Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea
Correspondence
Shin Hye Yoo, Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Dong-Yeop Shin, Department of Internal Medicine, Seoul National University Hospital, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Dong-Yeop Shin
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
Correspondence
Shin Hye Yoo, Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Dong-Yeop Shin, Department of Internal Medicine, Seoul National University Hospital, Center for Medical Innovation, Biomedical Research Institute, Seoul National University Hospital, 101, Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Email: [email protected]
Search for more papers by this authorAbstract
Introduction
Patients with hematologic malignancies (HMs) often face challenges in accessing palliative care (PC) and receiving quality end-of-life (EOL) care. We examined factors associated with referrals to tertiary PC and the effects of tertiary PC on EOL care in patients with HMs.
Method
We included patients with HMs who were admitted to a university-affiliated hospital and died during hospitalization between January 2018 and December 2021. We investigated the receipt of PC consultations, patient characteristics, and EOL care indicators.
Results
Overall, 487 patients were included in the analysis, with 156 (32%) undergoing PC consultation. Sex, residence, disease status, and admission purpose were factors associated with the likelihood of PC consultation, and there has been an increasing trend in the frequency of consultations in recent cases. A higher proportion of patients who received PC completed advance statements and life-sustaining treatment documents. Patients who received PC had lower rates of aggressive EOL care, including chemotherapy and intensive care unit admission, than those who did not receive PC. Notably, PC reduced the number of blood transfusions.
Conclusion
Tertiary PC aims to reduce aggressive EOL care through patient-centered goal-of-care discussions. Therefore, there is an imperative need for concerted efforts toward seamless integration of PC.
CONFLICT OF INTEREST STATEMENT
None of the authors have any conflicts of interest to disclose.
Open Research
DATA AVAILABILITY STATEMENT
The datasets generated during the current study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| ejh14165-sup-0001-Figures.docxWord 2007 document , 309.7 KB | Figure S1. Patient flowchart diagram. Figure S2. ICU-related end-of-life care indicators according to hematologic malignancy subtypes. Figure S3. Mean value of daily transfusion amount for the last week of life by PC consultation. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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